Radiation and chemotherapy are widely used against cancer. Both of these treatments, and their combination, result in toxicity manifested as pain, nausea and emesis, emotional distress, and cognitive impairment. Management of toxicity has received relatively little attention in research, partly because of the heterogenous nature of disease and therapy across patients. This application targets problems of toxicity in a highly controlled hospital setting where patients with hematologic malignancy or aplastic anemia receive vigorous regimens of chemoradiotherapy or chemotherapy in preparation for bone marrow transplantation. The proposed five-year research program is comprised of three projects. The first introduces medical and behavioral medicine interventions for toxicity-induced nausea/emesis and emotional disturbance. It consists of a series if controlled clinical outcome studies intended to produce an optimal package of palliative case interventions for the major complications of toxicity. A compehensive toxicity data base will be developed. The second project targets oral pain, a frequent complication of both radiation and chemotherapy. In this project is a human laboratory research program that will develop and refine intervention for oral pain control that will be used in the clinical setting. The third project will expand and investigate the data base developed in project one in order to identify biologial factors that determine the incidence and severity of toxic complications. This project will also assess the impact of pain, nausea/emesis and psychological problems on duration of hospitalization and cost of care. These three projects, which have been designed to be interdependent, will be carried out by a multidisciplinary team comprised of clinical, laboratory and social science investigators. A program Core will organize resources, provide statistical support, data base management, electronic services and secretarial service. The Core will also coordinate regular scientific meetings and semiannual programs for visiting research consultants and scientific workshops. The information gained by the proposed program is expected to benefit all patients receiving radiation or chemotherapy, those in bone marrow transplant settings, and others such as trauma or postsurgery patients who suffer pain or emotional distress.